Alternative Registration Form

Rocky Mountain Peer Tutoring Conference    March 6-7, 2009
                     Sponsored by the Rocky Mountain Writing Centers Association
                     Hosted by Southern Utah University, Cedar City, Utah

Please direct inquiries and mail to Dr. Julie Simon/English Southern Utah University 351 West University Boulevard Cedar City, UT 84720

e-mail: simon@suu.edu

Submission Deadline: Feb. 23, 2009 (although “early bird” registration still applies through Friday, the 28th).
Please feel free to copy this form as needed or to submit by e-mail to simon@suu.edu

Registration Form--please copy and paste into an e-mail message and send to:
simon@suu.edu

                   Administrator:
                   Institution:
                   Mailing Address:
                  City:                                        State:                           Zip:
                        Office Phone: (     )                            Home Phone: (     )
                        Email:

                        Conference Fees:
                        Administrators
                        Pre-registration (by 02/28/09): ______x $40
                        Late/On Site Registration: ______x $45
                        Administrator Subtotal: ______
                        Students
                        Pre-registration (by 02/28/09): ______ x $20
                        Late/On Site Registration: _____x $25
                        Student Subtotal: _______
                        Total Fees Due:

Number of tutors planning to attend the Friday evening Clue game and movie showing: ___________________.

(This event will be 6-9 p.m. Pizza will be served.)

Student Name Email
____________________________________ _______________________________

____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
   Student Name                                                                              Email
____________________________________          _______________________________

____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________
____________________________________          _______________________________

Student Name Email
____________________________________ _______________________________